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2025 CPT code 22319

Open treatment of odontoid fracture and/or dislocation, anterior approach, with internal fixation and grafting.

This code includes internal fixation and bone grafting.It does not include the harvesting of autogenous bone graft, which should be reported separately. Modifier 62 can be used if two surgeons work together as primary surgeons performing distinct parts of the procedure.

Modifiers, such as 22 (increased procedural services), 51 (multiple procedures), 62 (two surgeons), and 76 (repeat procedure by same physician) may apply in specific situations.

Medical necessity is established by documentation demonstrating instability, neurologic compromise, or significant pain caused by the odontoid fracture or dislocation.

The surgeon makes an incision in the neck, exposes the fractured odontoid, and reduces the fracture or dislocation. Internal fixation and bone grafting are used to stabilize the repair.Fluoroscopy is typically used to guide screw placement.

In simple words: The procedure involves repairing a fracture or dislocation of the odontoid (the uppermost bone in the neck) through an incision in the front of the neck. It includes internal fixation and bone grafting to stabilize the bone.

Open treatment and/or reduction of odontoid fracture(s) and/or dislocation(s) (including os odontoideum), anterior approach, including placement of internal fixation; with grafting.

Example 1: A patient sustains a type II odontoid fracture in a motor vehicle accident and undergoes open reduction and internal fixation with bone grafting., A patient with os odontoideum (where the odontoid is not fused to the second cervical vertebra) experiences instability and requires surgical stabilization and fusion., A patient with an unstable odontoid fracture undergoes anterior open reduction, internal fixation with screw placement, and bone grafting for fusion.

Documentation should include details of the injury, type of odontoid fracture or dislocation, surgical approach, type of internal fixation used, source of bone graft, and intraoperative findings.

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